[Radiological acute diagnosis in suspected perforation of the large intestine]

The last decade has seen changes in imaging procedures in patients with suspected colon perforation. Many traditional emergency imaging techniques have been replaced with helical CT, that can be performed with great accuracy, less patient discomfort and, probably, decreased cost. Because CT is more sensitive than conventional radiography in identifying subtle pneumoperitoneum, helical CT is ideally suited for rapid evaluation of the abdomen for patients with acute pain from suspected perforation. CT is often indicated when free air is seen at conventional radiography but perforation site is not clear. It is also indicated when air is strongly suspected despite normal abdominal radiographic findings.